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Journal of Korean Neurosurgical Society > Volume 42(2); 2007 > Article
Journal of Korean Neurosurgical Society 2007;42(2): 97-102.
Relations between Airway Narrowing and Prevertebral Soft Tissue Swelling after Anterior Cervical Spine Surgery: The Value of Lateral Neck Radiographs.
Hee Seop Kim, Jin Young Youm, Hyon Jo Kwon, Seung Won Choi, Seon Hwan Kim, Hyeon Song Koh
Department of Neurosurgery, College of Medicine, Chungnam National University, Daejeon, Korea. jyyoum@cnu.ac.kr
The authors attempted to evaluate the pattern of the airway narrowing due to prevertebral soft tissue swelling after surgery of the anterior cervical spine and their clinical significances using plain cervical X-ray images.
Twenty-four patients undergoing anterior cervical spine surgery were reviewed from January 2004 to December 2005. Postoperatively, in daily basis, lateral radiograph of the neck was obtained in neutral position. We measured the upper airway diameter above and below the epiglottis level and prevertebral soft tissue diameter everyday for a week and finally 2 weeks after surgery using their simple lateral cervical X-ray films.
Both airway narrowing and prevertebral soft tissue swelling were maximum in postoperative 2 days, and decreased rapidly in postoperative 7 days. Airway narrowing was aggravated postoperatively but slowly decreased as prevertebral soft tissue swelling diminished. But, the severity of airway narrowing showed no clinical correlations with clinical symptom and radiologic severity.
Not all patients who show severe airway narrowing and prevertebral soft tissue swelling on their plain cervical X-ray film complain respiratory insufficiency. But, the patients with undergoing anterior cervical spine surgery should be monitored carefully for respiratory insufficiency, especially during several days following operation because both airway narrowing and prevertebral soft tissue swelling become peak at postoperative 2-3 days.
Key Words: Soft tissue; Airway obstruction; Respiratory insufficiency
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